Abstract Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, because elderly people are a vulnerable group due to their biological, ...psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología , SEGG) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories seeks to aid in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment associated to laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is to further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics.
Similarities between the Atacama Desert (Chile) and Mars include extreme aridity, highly oxidizing chemistry, and intense ultraviolet radiation that promoted the photochemical production of ...perchlorates and nitrates. Concentration of these ions under hyperarid conditions led to the formation of nitrate‐ and perchlorate‐bearing deposits in ephemeral lakes, followed by later deposition of chlorides and sulfates. At some locations, such as the Salar Grande, hypersaline deposits have remained unaltered for millions of years. We conducted a drilling campaign in deposits of the Salar to characterize the preservation state of biological molecules. A 5 m deep discontinuous core was recovered and subjected to multitechnique analysis including the antibody microarray‐based biosensor LDChip300 and the SOLID (Signs Of Life Detector) instrument, complemented by geophysical, mineralogical, geochemical, and molecular analysis. We identified two units based on the mineralogy: the upper one, from the surface to ~320 cm depth characterized by a predominance of halite and anhydrite, and the lower one, from 320 to 520 cm, with a drop in halite and anhydrite and an enrichment in nitrate and perchlorate. Organic compounds including biomolecules were detected in association with the different depositional and mineralogical units, demonstrating the high capacity for molecular preservation. Hypersaline environments preserve biomolecules over geologically significant timescales; therefore, salt‐bearing materials should be high‐priority targets for the search for evidence of life on Mars.
Key PointsPreservation of biomolecules in salty deposits of AtacamaSame salty deposits are found in MarsMars salt‐enriched deposits have a great astrobiological potential
A new analytical variation of bioelectrical impedance vector analysis (BIVA), called specific BIVA, has shown to be more accurate in detecting changes in fat mass than classic BIVA.
To compare ...classic and specific BIVA in order to identify which is more strongly associated with psycho-functional and nutritional indicators in a group of institutionalised elderly patients with dementia.
Cross-sectional study. Fifty-four patients (34 women, 20 men) with dementia in moderately severe to very severe stages and aged 60–95years underwent geriatric nutritional assessment, including body mass index calculations, the Mini Nutritional Assessment, the Geriatric Nutritional Risk Index, and whole body composition analysis.
With specific BIVA (unlike with classic BIVA), significant differences were found between women with moderately severe and very severe dementia. In the BIVA conducted for body mass index, the confidence ellipses produced with the classic BIVA approach were highly overlapping; but with specific BIVA, significant differences were observed between the women in different nutritional categories (malnutrition, risk of malnutrition, normal weight and obesity). On the other hand, both approaches distinguished malnourished women from those who were at risk of malnutrition, according to the Mini Nutritional Assessment; and men with a moderate-high risk of malnutrition from men with no risk, on the basis of the Geriatric Nutritional Risk Index.
Overall, the findings of the present study suggest that specific BIVA is more effective than classic BIVA in identifying bioelectrical changes associated with psycho-functional and nutritional indicators in institutionalised elderly with dementia.
•Specific BIVA detects changes related to nutritional status better than Classic BIVA.•Specific BIVA detects changes in fat mass better than Classic BIVA.•Nutritional status is well correlated with resistivity and reactivity.
BMI is the most commonly used indicator to evaluate overweight and obesity, but it cannot distinguish changes in body composition. Over recent years, it has been demonstrated that bioelectrical ...impedance analysis (BIA) is a more accurate method for analyzing body composition. Bioelectrical impedance vector analysis (BIVA) has revealed its effectiveness as an indicator of nutritional status and hydration.
To assess the usefulness of bioimpedance analysis on the study of body composition in a group of children with overweight and obesity.
Cross-sectional observational study. The anthropometric parameters of 167 (79 were older than 12 years) overweight and obese children were recorded. Their body composition was analyzed using BIA and BIVA, and was classified based on different criteria. Concordance was analyzed (intraclass correlation coefficient, Bland-Altman analysis and weighted Kappa coefficient). The BIVA of the subgroups was compared using the Mahalanobis distance and Hotelling's T2. Statistical significance was considered for p<0.05.
The BMI revealed that the majority of the assessed subjects were obese, although 12% had a normal percentage of fat mass (%FM). The classification by Z-BMI and Z-%FM significantly discriminate between subjects with different levels of adiposity. In children over the age of 12, the classification of fat mass index also discriminates significantly between obesity and non-obesity. As anticipated, in the tolerance ellipses, most of the individual vectors were situated in the left lower quadrant.
BIVA reflects differences in the bioelectric patterns of children who are classified as being overweight or obese (BMI) and who have different levels of %FM and FMI. BIVA permits a fast and easy monitoring of the evolution of the nutritional state and changes associated with body composition, and it identifies those children whose body compartments may be precisely estimated using traditional BIA methods.
Harmful alcohol consumption among young people is a public health problem that needs important measures. Interventions in emergency department cases, such as crisis action, could be effective. The ...initial results of the Icaro-Alcohol Program (detection of young people under 22 years attended in the emergency department for alcohol consumption, a Brief Motivational Intervention (BMI) and referral to a prevention reference service (PRS) and prevention programs) are presented. The program objective is to reduce the harmful use of alcohol. Río Hortega University Hospital (HURH), Clínico Hospital (HCUV) and Medical Emergency Units (MEUs) were involved in the study developed in the city of Valladolid (Castilla y León, Spain). Training in program implementation was given to 53.8% of professionals (n=27) (73.3% HURH vs 45.6% HCUV), while 17.4% (n=41) were trained to develop BMI in the critical situation derived from the emergency (26.7% HURH vs 12.6% HCUV). A total of 93 cases were treated by the hospital emergency services, and all the cases treated by the MEUs were referred to the hospital, between June and December 2017. There were 49 urgent cases, and interventions were carried out in 21 of them (43%). Afterwards, 8 cases were referred to the PRS (38% of 21 intervened; 16% of the total number of cases). Interventions and referrals were greater in the hospital with more trained professionals. The older youth cases arrived last at night. They had other health problems associated and were less likely to agree to referral. The referral times to indicated prevention programs were met, but not to universal and selective programs. The action protocol is improved by focusing on children under 18, simplifying consent, improving BMI training, simplifying the intervention of professionals and carrying out individual preventive intervention from the PRSs immediately. The program will be implemented progressively in the rest of the provinces in Castilla y León.
To assess the association between whole-body and calf impedance vectors and muscle mass and strength in a group of elderly individuals.
We carried out a cross-sectional observational study on a ...sample of 113 elderly people. Anthropometric parameters (weight, height and body circumferences) were determined. Body composition was evaluated using conventional bioimpedance analysis (BIA) and vector bioimpedance analysis (BIVA) (whole-body and calf BIVAs), and muscle strength was determined (manual dynamometry). The results were analyzed using the Student t-test or the Mann-Whitney U, and the correlations using the Pearson or Spearman test. To compare BIVA results among the subgroups established, the Mahalanobis distance (dM) was calculated and the Hotelling T2 statistic was used. Statistical significance was set to p < 0.05.
Nearly half the sample was overweight. Based on waist circumference, 66.7% of the males and 94.9% of the females showed risk of metabolic complications; calf circumference indicated no risk of disability or skeletal muscle mass depletion. However, BIA and dynamometry detected risk of sarcopenia in more than half the subjects. Whole-body BIVA results agreed with those of the BIA, given that most impedance vectors in both sexes were to the right of major axis of the tolerance ellipses. This shows cell mass depletion. While the whole-body BIVA distinguished the subjects having loss of muscle mass and strength, the specific BIVA (calf) only did so in individuals with muscle mass loss.
Whole-body BIVA detects loss of muscle mass and strength, while calf BIVA only distinguishes subjects having muscle mass loss. The localized BIVA might be an alternative to conventional BIA or whole-body BIVA to assess body composition in the elderly.
•BIVA distinguish the subjects with reduced muscle strength and muscle mass from those with normal values.•Localized BIVA (calf BIVA) identifies subjects with reduced muscle mass.•Localized BIVA could be used when the conventional BIA or whole-body BIVA cannot be performed.•BIA, in one of its modalities, must be included routinely in geriatric nutritional status assessment.
Introducción: aunque se dispone de técnicas precisas y exactas para la estimación del GER, como la calorimetría indirecta (CI), en la práctica diaria se precisan métodos rápidos, fáciles de aplicar y ...económicos, como los modelos predictivos. Objetivo: desarrollar una nueva ecuación predictiva del gasto energetico en reposo (GER) para población española adulta sana. Métodos: se determinó el GER en 95 sujetos sanos con normopeso mediante CI. Se utilizó la regresión lineal múltiple para la obtención del modelo, empleando como criterios analíticos la Cp de Mallows y el R2 ajustado. Se estudió el comportamiento del modelo generado en una muestra de 39 sujetos con IMC ≥ 25 kg/m2 mediante el coeficiente de correlación intraclase (ICC) y la prueba de Bland-Altman. La significación se alcanzó con p < 0,05. Resultados: la edad media fue de 42 anos (rango: 23,0. 63,2). El valor medio del GER estimado fue de 1.589,1 kcal/d (312,0). La ecuación seleccionada fue: GER (kcal/d) = 1.376,4 - 308 Sexo (V = 0; M = 1) + 11,1 Peso (kg) - 8 Edad (anos) (R2: 0,68; EE: 175,95). El CCI entre el nuevo modelo predictivo y la CI fue de 0,901 (IC del 95%: 0,851 - 0,934) en la muestra con normopeso. La aplicación del modelo en la muestra de sujetos con IMC ≥ 25 kg/m2 alcanzo una buena concordancia (CCI de 0,880; IC del 95%: 0,772 . 0,937). Conclusiones: se presenta un nuevo modelo de estimación del GER para población sana española fácilmente aplicable en la práctica diaria, que incluye las variables sexo, edad y peso. La ecuación propuesta presenta un comportamiento adecuado en sujetos con IMC ≥ 25 kg/m2.
The Rover Environmental Monitoring Station (REMS) is one of NASA/MSL's instruments, which has been designed for measuring ambient pressure, humidity, wind speed and direction, UV radiation, and air ...and ground temperature (GT). The GT-sensor is dedicated to measure the real temperature of the Martian surface, integrating the IR energy coming from the ground. The existing IR spectral data of Martian dust, rocks and sediments allow for comparing the Martian spectra with the spectra of different terrestrial minerals and lithologies, and those of their alteration and weathering products. The FTIR reflectance of a set of selected astrobiologically significant minerals (including oxides, oxi/hydroxides, sulfates, chlorides, opal and clays) and basalt (as the main and most widespread volcanic Martian rock) was measured, considering different mixing amounts, and covering the specific working wavelength range of the REMS' GT-sensor. The results obtained show important percentage increases or decreases of reflectance in the entire wavelength range (e.g. basalt-hematite vs. basalt-magnetite) and specific variations limited to some spectral bands (e.g. basalt-smectite vs. basalt-jasper). The basalt reflectance percentage increases or decreases, even up to 100%, depending on the mixing of the different minerals. This unequivocally confirms the need for considering the chemical-mineralogical assemblages (and their textures) for any investigation and interpretation of Mars surface environment. Some complementary applications of this research on our planet, either in relation to the specific performances and characteristics of the GT-sensor autonomous recalibration system, or those oriented to carrying out similar studies on different types of terrestrial environmental settings, are also described.
Bioelectrical impedance vector analysis (BIVA) is increasingly used in clinical research to assess soft tissue hydration. It is known that physical characteristics of electrodes, such as low ...intrinsic impedance, low electrode/skin contact impedance and type of gel, affect the reliability of noninvasive bioimpedance assessments. The aim of this study was to determine the effect of intrinsic impedance of electrode on the bioimpedance vector displacement in RXc graph.
The intrinsic impedance is measured in nine pregelled disposable Ag/AgCl electrodes usually used for bioimpedance measures. The BIVA method is performed on 35 healthy volunteers using a 50 kHz phase-sensitive bioimpedance analyzer (BIA 101 Anniversary) with the lowest intrinsic impedance electrode and highest. The individual bioimpedance vector is plotted on the bivariate normal interval of reference population. The differences in the mean bioimpedance vectors obtained with each electrode are plotted, with their 95% confidence ellipses, on the dRXc graph. The paired one-sample Hotelling's T
-test is used to compare the differences of the mean bioimpedance vectors.
We found large variability in intrinsic resistance (11-665 Ω) and reactance (0.25-2.5 Ω) values of the electrodes analyzed and significant displacement (P<0.05) of bioimpedance vector positions in healthy adults according to the paired one-sample Hotelling's T
-test.
A robust study of all physical characteristics of commercial Ag/AgCl electrodes is necessary to reach consensus on pregelled Ag/AgCl electrodes valid for bioimpedance measurement. This information will enable BIVA users to avoid systemic errors when performing BIVA assessments, specifically when these measurements are used for clinical interpretations.
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